What are the medical requirements for professional pilots and air traffic controllers?

To become a professional pilot or an air traffic controller, an applicant must be in good health (including good hearing, good vision and good colour perception). However, certain medical conditions are permitted by some States, depending on individual circumstances and when in doubt about the importance of such a condition, it is always advisable to contact the Chief Medical Officer of the national Licensing Authority.

ICAO itself does not make medical fitness decisions in individual cases.

The medical Standards and Recommended Practices can be found in Annex 1 — Personnel Licensing (mainly in Chapter 6). Annex 1 is not available free of charge and can be purchased directly online from ICAO through the Document Sales Unit. Although Annex 1 is not available free of charge, the ICAO Manual on Civil Aviation Medicine (Document 8984) can be found on ICAO's public website. The lastest (third) edition was published in 2012.

There is no requirement for uncorrected vision for medical certification of any Class; only visual performance, with or without correction, needs to be considered. Distant visual acuity with or without correction shall be 6/9 (20/30) or better in each eye separately, and binocular visual acuity shall be 6/6 (20/20) or better. In cases where the uncorrected visual acuity is worse than 6/60 (20/200), a full ophthalmic examination is required, the purpose of which is (1) to ascertain good visual performance, and (2) to identify any significant medical condition, should one be present.

ICAO provisions permit the use of contact lenses, and applicants who have undergone refractive surgery such as keratotomy, LASIK, etc. may be assessed as fit if they are "free from those sequelae which are likely to interfere with the safe exercise of their licence."

Some States and some airlines, have more stringent requirements. Before opting for irreversible eye procedure, an individual holding a pilot licence or considering applying for one should consult the national authority's policy concerning the intended procedure.

It is recommended that prospective applicants contact (a) the national Licensing Authority and (b) the airline to which they intend to apply for training or employment, to ensure they are aware of any medical requirements prior to commencing training.

Can a colour blind person have either a private pilot, a commercial pilot or an air traffic controller licence according to the ICAO regulations?

It is very rare for someone to be colour "blind" i.e. cannot see any colour at all. Most of those with a deficiency can see some colours quite well but not all colours or all shades of colour. The ICAO medical provisions in Annex 1 — Personnel Licensing, state that an applicant "shall be tested for the ability to correctly identify a series of pseudoisochromatic plates". Such a test displays different numbers (or shapes or letters) that are made up of dots that are coloured differently from background dots. Colours are chosen so that individuals with a colour vision deficiency cannot reliably differentiate the number from the background.

Individuals who fail to achive an adequate score in this test can nevertheless be accepted for licensing if they can "readily distinguish the colours used in air navigation and correctly identify aviation coloured lights". Depending on the country in which the application is made, this secondary test may take the form of a device (called a "lantern") that requires an applicant to identify different coloured lights e.g. red, green and white and sometimes, depending on the exact lantern type, additional colours. There are other tests becoming available that make use computer technology for assessing colour vision. As different countries apply different tests it is necessary to inquire of a particular Licensing Authority the details of the test it employs.

For private pilots only, an applicant who fails both tests can be licensed as long as his/her licence is restricted "Valid daytime only.

What are ICAO provisions about coronary angioplasty and coronary artery by-pass grafting (CABG)?

The current regulations can be found in Chapter 6 of Annex 1 — Personnel Licensing, paragraph 6.3.2.5 (6.4.2.5. and 6.5.2.5). The paragraph is identical for all classes of medical assessment and states:

6.3.2.5.1 An applicant who has undergone coronary by-pass grafting or angioplasty (with or without stenting) or other cardiac intervention or who has a history of myocardial infarction or who suffers from any other potentially incapacitating cardiac condition shall be assessed as unfit unless the applicant's cardiac condition has been investigated and evaluated in accordance with best medical practice and is assessed not likely to interfere with the safe exercise of the applicant's licence or rating privileges.

Can a person suffering from sickle cell disease or thallassaemia become a professional pilot?

Annex 1 — Personnel Licensing states:

6.3.2.17 Applicants with diseases of the blood and/or the lymphatic system shall be assessed as unfit, unless adequately investigated and their condition found unlikely to interfere with the safe exercise of their licence and rating privileges.

Note. — Sickle cell trait and other haemoglobinopathic traits are usually compatible with fit assessment.

However, since the decision will be taken by the Aviation Medicine Department of the Licensing Authority in the State of application, any question referring to an individual case should be addressed to the Chief Medical Officer of the national Licensing Authority.

What are the ICAO Standards and Recommended Practices for medical facilities at international airports?

While provisions on medical facilities, ambulances and hospitals are mentioned in the ICAO Annexes and other pertinent materials, the decision on what to provide is left to the local authorities.

However, some advice and guidance can be found in the following ICAO documents (available for purchase from
ICAO online store):

Annex 14 —
Aerodromes, in Chapter 9, paragraph 9.1, that an emergency plan shall be established and that the plan shall coordinate the response of all existing agencies, including medical and ambulance services.

In Doc 9137-AN/898 —
Manual of Airport Services, more detailed advice is given in Part 1 – Rescue and Fire Fighting – and in particular, in Part 7 – Airport Emergency Planning.

In November 2014 Amendment 172 to Annex 1 — Personnel
Licensing became applicable, concerning the upper age limit for pilots
engaged in international commercial air transport operations, as follows:

“2.1.10 Limitation of privileges of pilots
who have attained their 60th birthday

and curtailment of privileges of pilots who
have attained their 65th birthday

A Contracting State, having issued pilot licences, shall
not permit the holders thereof to act as pilot of an aircraft engaged in
international commercial air transport operations if the licence holders have
attained their 60th birthday or, in the case of operations with more than one
pilot, their 65th birthday.

Note.— Attention is drawn to 1.2.5.2.3 on the validity
period of Medical Assessments for pilots over the age of 60 who are engaged in
commercial air transport operations.”

The Standard
limits the privileges for pilots in single-pilot commercial air transport
operations to 60 years of age, while extending that limit to 65 years of age
for multi-pilot operations. This applies to operations conducted in all
categories of manned aircraft and is valid for all pilot positions designated
by an operator.

Those seeking information concerning States that may
authorize pilots to fly in their airspace after reaching the age of 60 or 65
years, as applicable, are advised to contact individual Civil Aviation
Authorities.

ICAO specifies an annual medical assessment for those
under 60 years who are engaged in two-pilot operations but when over 60, a
six-monthly medical assessment is necessary.